Replication paper 13

Stretching HIV treatment: A replication study of task shifting in South Africa

3ie Replication paper 13, 2017

Baojiang Chen and Morshed Alam conducted a replication study of Fairall and other’s influential paper, “Task shifting of antiretroviral treatment from doctors to primary-care nurses in South Africa (STRETCH)”. The original study examined a critical challenge to widespread HIV treatment in South Africa by conducting a cluster-randomised evaluation to determine the efficacy of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme on patient health outcomes. The original authors found that STRETCH did not decrease the mortality rate as compared to standard care. The intervention was more effective than the standard care system in patients with CD4 counts of 201-350 cells/µL as compared to patients with CD4 counts of 200 cells/µL or fewer. Although, the proportion of STRETCH patients with an undetectable viral load one year after enrolment was equivalent to that among the control patients.

In this replication study, the researchers conducted push button, pure, and measurement and estimation analyses. Although they find some minor differences between the published results, they generally replicated the published findings.